DEAR DR. ROACH: Three months ago, I slammed the fingertip of my left index finger in a drawer. The fingertip is still swollen and painful. My doctor sent me for an X-ray, and there is no fracture. I can bend it at the joint, but cannot put pressure on the fingertip. I looked online, and read something that said a fingertip crush injury can take six months to a year to heal, and the swelling may never go away completely.
Can this possibly be true? Why does it take so long? Is there anything I can do to help it heal? I can get along OK without using the finger for everyday functioning, but I am a guitar player, and I really need to use that fingertip to play. Is there hope that I will be able to play again someday? I would be very sad to have to give it up. — D.L.
ANSWER: Crush injuries to the fingertip often do take months to heal completely, due to the fact that there isn’t a lot of room in the fingertip and that there are many important structures in the fingertip, and that a little bit of inflammation can cause pain and loss of function for a long time.
Fortunately, most everybody does regain complete use of the hand, and I wouldn’t sell your guitar just yet. Think about what Pete Townshend did to his hand, and he’s still a pretty good guitar player.
DEAR DR. ROACH: My 18-year-old grandson has just been diagnosed with superior mesenteric artery syndrome. It sounds extremely serious. Would you be able to tell me more? I am very worried. — G.D.
ANSWER: The superior mesenteric artery is one of the critical arteries that supplies blood to the intestines. Directly underneath the SMA is the duodenum, the first part of the small intestine. In SMA syndrome, loss of the normal fat around the duodenum causes the artery to constrict the duodenum, causing a compression of the duodenum and an obstruction to food going through.
Serious weight loss due to medical illness, surgery or anorexia nervosa is the most common cause of SMA syndrome. It’s a difficult diagnosis to make, and there is some controversy about what criteria are used for diagnosis.
If weight loss is the underlying cause of SMA syndrome, then nutritional support and weight gain become the primary treatment. Surgery is sometimes necessary.
©2016 North America Synd.